Transference Issues in the Treatment of Mexican American Women Who Were Sexually Abused in Childhood

Abstract

This study explores the effect on therapy of positive and negative transferences experienced by Mexican American women during treatment to address their childhood sexual abuse. Individual interviews were conducted with six Mexican American women, all of whom received treatment for childhood sexual abuse. The resulting qualitative data was examined using interpretive phenomenological analysis. Positive transference themes of trust, understanding, comfort, closeness, and idealization were associated with increased engagement in and good feelings about therapy. Negative themes, which contributed to decreased engagement in the therapy, arose from feeling the therapist did not listen, was judgmental or aggressive, or lacked attunement. The failure of a therapist to attune to and respect the participants’ culture—including gender roles and values related to respect and advice—led to a negative transference the participants directly associated with rejecting the therapist, withholding their story, or withdrawing from therapy. For some participants, sharing the same ethnic identity and language was part of their positive transference, allowing them to feel most accurately understood. Positive transference reactions are instrumental to building the therapeutic relationship, and this study reinforces the importance of cultural competence to establish a transference that will allow for the development of trust and therapeutic engagement. Language preference should be addressed at the beginning of treatment and the patient referred out if the therapist is not a good cultural/lingual match. The findings emphasize the importance of Therapists need to explore patients’ negative transferences within the patient’s cultural context, taking responsibility for cultural biases in their countertransference.